Dr. John Chia and Enterovirus. Old hat? Nope - a key.

Recently, the 12th Invest in ME conference in London ended. This ME/CFS conference is three days of serious research discussion and presentations. It is one of the best conferences on difficult diseases. The sponsors Richard and Pia Simpson exert an extreme effort to put on this conference, a conference which expands in scope every year. These two individuals are extraordinary people.

One wonders, with all the comprehensive research at this conference, if Dr. Chia and his Enteroviral research were even mentioned at the Invest in ME conference conversations this year?

Is it possible that the low level of response to his research will continue indefinitely? Let's hope not.

Dr. John Chia knows that enteroviruses are a cause of ME/CFS.

I first met Dr. John Chia at the Invest in ME conference many years ago. Dr. Chia made a presentation on enterovirus and ME/CFS. He has made several other presentation at Invest in ME and I have written about him before, here and here and here and here.

Recently I came upon the NIH RFI request sent out this spring. Various people responded and the publication of responses can be found here. Dr. Chia's is the third response down, talking about his subject - enteroviral involvement in ME/CFS. The real question is if anyone - specifically the NIH - will pick up the thread.

Dr. Chia made a three-hour presentation on Enteroviruses at the IACFS/ME conference in the fall of 2016. In it, he makes the case that he has been making for many years now.

Dr. Chia keeps working on enteroviruses involvement in ME/CFS. He is undeterred and is committed to continue until there is a solution. In the meantime, Dr. Chia treats patients with oxymatrine. A certain percentage respond. He also uses Epivir in some cases. More recently he recommends dihydroquercitin and specifically Swanson's Russian Rejuvenator. Dihydroquercitin appears to inhibit coxsackie b4 virus and stabilizes mast cells. It has various other activities - anti-inflammatory, neuroprotective, combats oxidative stress - that you can read about online. It suppresses the release of histamine.

Dr. Chia has no problem with the recent metabolome data coming from Naviaux, seeing it as a step in the process of ME/CFS. He believes that a number of drugs might modulate the cellular function in the brain but eventually the viral replication or related mechanisms will have to be inhibited. This will come with anti-virals against coxsackie B and Echo viruses. It is known that two European companies are working on a anti-viral coxsackie drug, but they keep their work very quiet. The companies working on this have extra motivation now, knowing that their market for this drug is greater than originally thought.

By sheer chance, my daughter started doing the ARUP coxsackie antibody test in 2005. Only in 2007 did I hear Dr. Chia state the importance of doing this specific test. My daughter's antibodies to CVB4 and CVB3 have been at the top of the range for ten years. To me this means something, as opposed to many other test results, which are indeterminate. I know a lot of people with ME/CFS - and a good number of doctors who try to treat it. To all of them I urge doing the coxsackie antibody test via neutralization at ARUP. Amazingly, I have yet to convince one patient or one doctor to do this test. This in itself says something - and it is not good. It appears that they just do not want to know.

More can be read on Dr. Chia and enteroviruses on the Phoenix Rising forum and another one on PR here.

There are a number of interesting responses in the NIH RFI cited above. For instance check out Dr. William Weir's response. It is the second one from the top.

"ad astra per aspera" - Dr. John Chia's ideas taking hold

("ad astra per aspera" - "a rough road leads to the stars")

Several summaries have emerged of the IACFS/ME conference, for those who are interested in the details. The first is the transcription of Dr. Komaroff's summary at the end of the conference. We have Patricia Carter of ME/CFS forums to thank for this. Another summary is by Dr. Charles Lapp. It can be found here. 

Several paragraphs in each summary caught my interest and both deal with a favorite subject of mine: Dr. John Chia and his research into Enterovirus and ME/CFS.

From Patricia Carter's transcription of Dr. Komaroff:

"Dr Chia reported again at this meeting, as he has in the past, the expansion, the latest summary of data from a remarkable report and a remarkable amount of work, Enterovirus Antigen and nucleic acid found in biopsy samples from stomach in cases and control subjects. Finding very marked differences in the frequency of both antigen and nucleic acid in CFS patients compared with controls. He then also reported that when you took the biopsy specimens that these tests suggested contained enterovirus and injected them into mice that, in fact, you found when you sacrificed the mice, evidence of enteroviral infection, a virus in the mouse, indicating that this thing lit up looking like it might be an infectious agent of the biopsy tissue actually produced an infection in another animal. 

To me, these results are very impressive, but it's also depressing to see that, to my knowledge, no academic enterovirologists have sought to try to reproduce this, not even in bulk, to take the samples that already have been collected at enormous effort by Dr. Chia and test them themselves to see if they get the same results that Dr. Chia does. It's a great shame and I hope it changes." 

In fact two of the infected mice died over a weekend, one on a Friday, one on a Monday. "If they do not believe in death, then what do they believe in?" At least one enterovirologist, and perhaps two,  have worked with Dr. Chia's samples.

And then there is this from Dr. Lapp:

"Dr John Chia is an infectious disease specialist and pathologist from Lomita CA. He and his son contracted CFS/ME and were found to have enterovirus infections in their stomachs (see his article in the Journal of Clinical Pathology, Jan 2009. After treatment with a Chinese herbal called oxymatrine (there is no other known therapy for EV) both have recovered and stayed well. Dr. Chia reported to us on further EV studies from his lab. To demonstrate the infectiousness of EV, Chia injected the lysate (Osterized tissue or homogenate) from 24 EV-positive human stomach biopsies into immune deficient SCID mice. When the mice were later sacrificed, 13 out of 20 were positive for EV in their spleens, but only 1 of 10 control mice were positive. However, Chia could not culture the virus from any of the spleens suggesting that although the infections were transferred, incomplete viruses were formed in the receiving mice. In a second study, Chia obtained pathology specimens from 27 women with CFS/ME who had undergone total hysterectomy or salpingo-oophorectomy for chronic pelvic pain. 24 or 27 specimens stained positive for EV, whereas none of 15 healthy control specimens were positive. Three SCID mice were injected from EV-positive specimens and the mice were sacrificed at either 2 or 5 weeks. Spleens and fallopian tubes stained positive for EV at both 2 and 5 weeks, although spleen stain was less obvious at 5 weeks. Western blot studies of all mouse fallopian tubes demonstrated enteroviral proteins. (Ed. note (Lapp) Dr. Chia is making a strong case for enterovirus as a common trigger for CFS/ME, and these studies imply that the infection is transferable. I found it interesting that chronic pelvic pain was localized to the infected fallopian tube in his patients, and that surgery relieved the pain. Sadly, no one else has taken on the task of confirming Dr. Chia's studies. Also there is no known antiviral therapy for EV - just an ill tolerated herbal preparation. Hopefully someone with Chia's expertise will investigate this further and confirm these important findings!)"

It has been seven long years since Dr. Chia's important paper of potential enteroviral involvement in ME/CFS. No one has significantly picked up on his study. As the backbone of his work, Dr. Chia has studied and revisited the history of ME especially in the UK. He has personally re-ignited important and forgotten associations. Dr.Chia is not coming out of nowhere on this. 

"We need to declare EV as one of the causes of ME/CFS. It has been 30 years!"

"Enteroviruses need to be accepted as one of the causes of this illness this year, or else we will wait another ten or more years before a drug will be available for this disease. You need to ask the researchers at Stanford and at the meeting why they are not working on enteroviruses."

I personally have witnessed several virologists flatten Dr. Chia's work. A prominent virologist (regarding Dr. Chia's work, which I had sent him) gave this blunt assessment: "It's crap". There is evidence that this prominent virologist might have altered his views - and perhaps might be willing to help.

We need to move on beyond these attitudes and find out what Dr. Chia is finding. Dr. Chia himself says: "I have spent considerable time trying to convince that I am right. Now it is time for others to prove that I am wrong."

After this IACFS/ME conference it seems that things are turning in a more positive direction for Dr. Chia's stupendous efforts in trying to get at this nasty illness. For those interested, there is more information on Patrick W. Calvins' Quixotic blog. 

And then there is the recent very exciting news regarding new drugs for Hep C. One drug, Sovaldi, from Gilead was approved by the FDA and is both well tolerated and extremely successful in treating Hep C. Two more amazing Hep C drugs are in the pipeline, one from Abbot and another from Bristol-Myers. There is some hope that one of these drugs might be effective against enteroviruses. "If this proves true, it will make all the difference in the world".

So there is some urgency here, and some real hope - but only if Dr. Chia's work is followed up on. 

Dr. John Chia with Llewellyn King, 3rd section

Here is the third section of a very fine interview with Dr. John Chia. The interview is conducted by Llwellyn King. Mr. King does us a great service in conducting these ME/CFS Alert interviews, and presenting ME/CFS information with such clarity. Clarity is something that is in short supply in this illness.

This interview should be required viewing material for anyone who is interested in this illness. Dr. Chia has a firm grasp on a very significant aspect of this complex illness. His ideas are attached to solid evidence - also something that is in short supply in this illness. It is always surprising to me that more clinicians and researchers are not assisting Dr. Chia and his ideas, which incidentally are not new ideas, but take us back to the very first studies of this illness in the UK.

It would be nice to have some validation of Dr. Chia's ideas through other clinical studies involving other clinicians and researchers. Perhaps I am just not privy to this information, but it seems that Dr. Chia is working on his own here - and to me this is a problem, as he has what looks like a significant part of the answer.

I wonder what Dr. Chia would think of Anatabloc? I wonder if he uses it with his patients?

I have written in other posts about Dr. John Chia - for those who might be interested.

More with Dr. John Chia - Llewellyn King Interview

Here is the second part of an ME/CFS Alert interview with Dr. John Chia. Llewellyn King does such a fine job at interviewing his subjects, proving that interviewing is an art. And his subject here, Dr. Chia, is about the best. Dr. Chia has done a great deal of clinical research characterizing a significant insult or pathogen in many ME/CFS patients - enteroviruses (various coxsackie and echo viruses). Here Dr. Chia speaks about treatment with oxymatrine (Equilabrandt), which seems to work in about 50% of cases.

I wonder if any hepatitis drugs in the pipeline would be useful for enteroviruses?

I also wonder if there is some manner in which oxymatrine could be made to be beneficial in a higher percentage of patients - a pretreatment of some sort with diet, gut ecology, and MAF-like substances. Any number of other ways to help lower the collective burden on the immune system might raise the success rate of oxymatrine. Dr. Chia seems to be such an innovator and so individualistic in his thinking - one would have to believe he is thinking along the lines of how to improve efficacy of the one weapon that he has against enteroviruses.

Llewellyn King interview with Dr. John Chia

Here is an excellent interview by Llewellyn King with Dr. John Chia of Torrance, CA. Dr. Chia is one of the foremost clinician/researchers in ME/CFS focusing on patients who have enterovirus involvement. Once Dr. Chia starts talking I always want to hear more - as this doctor has his finger on the pulse of a significant part of this illness. Fortunately, Llwellyn King promises us more conversation with Dr. Chia in an upcoming interview. Llewellyn King does a very great service in bringing interviews with significant players in this illness, those who are looking for answers. The full set of interviews of ME/CFS Alert can be found here on youtube.